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Analysis of Clinical and Radiographic Outcome of the Reconstructive Surgery for the Cavovarus Foot Deformity
J Korean Foot Ankle Soc. 2014;18:62-67
Published online June 15, 2014
© 2014

Hong-Geun Jung, Jae-Yong Park*, Dong-Oh Lee, Joon-Sang Eom, Seung-Hee Chung

Department of Orthopedic Surgery, Konkuk University School of Medicine, Seoul,
*Department of Orthopedic Surgery, Hallym University Sacred Heart Hospital, Anyang, Korea
Correspondence to: Joon-Sang Eom
Department of Orthopedic Surgery, KonKuk University School of Medicine, 120 Neungdong-ro, Gwangjin-gu, Seoul 143-729, Korea
Tel: 82-2-2030-7638, Fax: 82-2-2030-7369, E-mail: eoms1234@naver.com
Received March 30, 2014; Revised April 23, 2014; Accepted April 30, 2014.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Purpose: Reconstructive surgeries for equinocavovarus foot deformities are quite variable, including hind-midfoot osteotomy or arthrodesis, soft tissue procedure, tendon transfers, etc. Comprehensive evaluation of the deformity and its etiology is mandatory for achievement of successful deformity correction. Few studies in this field have been reported. We report on the clinical and radiographic outcome of reconstruction for cavovarus foot deformities.
Materials and Methods: The study is based on 16 feet with cavovarus foot deformities that underwent bony and soft tissue reconstructive surgery from 2004 to 2008. We evaluated the etiologies, varieties of surgical procedures performed, pain score, functional scores, and patient satisfaction and measured the radiographic parameters.
Results: The average age at the time of surgery was 39.4 years old, with a male/female ratio of 9/4 and an average follow-up period of 23.9 months (range, 12∼49 months). The etiologies of the cavovarus deformity were idiopathic 7 feet, residual poliomyelitis 5 feet, Charcot-Marie-Tooth disease 2 feet, and Guillain-Barre syndrome and hemiplegia due to cerebrovascular accident sequela 1 foot each. Lateral sliding calcaneal osteotomies were performed in 12 feet (75%), followed by Achilles tendon lengthening and plantar fascia release in 11 feet (69%), and first metatarsal dorsiflexion osteotomy/arthrodesis and tendon transfer in 10 feet (63%). Visual analogue scale pain score showed improvement, from an average of 4.2 to 0.5 points. American Orthopaedic Foot and Ankle Society ankle-hindfoot score showed significant improvement, from 47.8 to 90.0 points (p<0.05). All patients were satisfied. Ankle range of motion improved from 27.5o to 46.7o. In radiographic measurements, calcaneal pitch angle improved from 19.1o to 15.8o, Meary angle from 13.0o to 9.3o, Hibb’s angle from 44.3o to 37.0o, and tibio-calcaneal axis angle from varus 17.5o to varus 1.5o.
Conclusion: We achieved successful correction of cavovarus foot deformities by performing appropriate comprehensive reconstructive procedures with improved functional, radiographic measures and high patient satisfaction.
Keywords : Cavus foot, Deformity, Reconstruction


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